Phillipe Pinel and the foundations of modern psychiatric nosology

Phillipe Pinel (1745–1826) played a major role in the foundation of modern psychiatric nosology. Much of his contribution, historically contextualized within the enlightenment generally and post-Revolutionary France more specifically, can be summarized through five themes in his background, education and writings. First, he applied an inductive, enlightenment-informed natural science approach to classification adapted from the biological sciences, which he had studied, and applied this to large samples of mentally ill individuals in Parisian asylums, frequently referring to ‘varieties’ and ‘species’ of insanity. Second, Pinel's classificatory approach rejected metaphysical and highly speculative etiologic theories in favor of a Baconian inductive approach utilizing observational data. Third, Pinel advocated repeated assessments of patients over time, feasible given long in-patient stays. Fourth, trained in philosophy, Pinel relied on philosophically informed models of the mind and of insanity. Fifth, Pinel extensively utilized faculty psychology to understand and classify mental illness. He anticipated further developments of nineteenth-century psychiatric nosology by challenging the then-dominant intellectualist models of insanity, adopting a humanistic-informed emphasis on the importance of symptoms alongside signs, arguing that passions could be the primary cause of mental illness, and trying to infer causal inter-relationships in psychiatric patients between disturbances in affect and understanding.

From Description to Explanation: Integrating Across Multiple Levels of Analysis to Inform Neuroscientific Accounts of Dimensional Personality Pathology

Dimensional approaches to psychiatric nosology are rapidly transforming the way researchers and clinicians conceptualize personality pathology, leading to a growing interest in describing how individuals differ from one another. Yet, in order to successfully prevent and treat personality pathology, it is also necessary to explain the sources of these individual differences. The emerging field of personality neuroscience is well-positioned to guide the transition from description to explanation within personality pathology research. However, establishing comprehensive, mechanistic accounts of personality pathology will require personality neuroscientists to move beyond atheoretical studies that link trait differences to neural correlates without considering the algorithmic processes that are carried out by those correlates. We highlight some of the dangers we see in overpopulating personality neuroscience with brain-trait associational studies and offer a series of recommendations for personality neuroscientists seeking to build explanatory theories of personality pathology.

Linking RDoC and HiTOP: A new interface for advancing psychiatric nosology and neuroscience

Dimensional models of psychopathology have emerged to accelerate progress in the way psychopathology is classified, studied, and treated. This article proposes an interface between two major dimensional frameworks, in order to leverage their complementary nature: the Research Domain Criteria (RDoC) and the Hierarchical Taxonomy of Psychopathology (HiTOP). RDoC is a research framework rooted in neuroscience aiming to further the understanding of the transdiagnostic biobehavioral processes underlying psychopathology and ultimately inform future classifications. HiTOP is a system that was derived from the observed covariation among symptoms of psychopathology and promises to provide more informative targets for research and treatment than traditional diagnostic manuals. We performed a comprehensive literature review to delineate connections between dimensions included in RDoC (constructs and subconstructs) and HiTOP (spectra and subfactors). The resulting RDoC-HiTOP interface can facilitate progress in uncovering the etiology of psychopathology and developing a unified, dimensional, and biobehaviorally-grounded psychiatric nosology that systematically describes both clinical syndromes and the processes that underpin them. We conclude with future directions and practical recommendations for using this interface.